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Aggression and Anger

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Aggressive behaviors may be verbal or physical. They can occur suddenly, with no apparent reason, or result from a frustrating situation. While aggression can be hard to cope with, understanding that the person with Alzheimer's or dementia is not acting this way on purpose can help.

Causes

Aggression can be caused by many factors including physical discomfort, environmental factors and poor communication. If the person with Alzheimer's is aggressive, consider what might be contributing to the change in behavior.

The main cause of behavioral symptoms associated with dementia is the progressive deterioration of brain cells, but other factors — such as pain — also can cause symptoms or make symptoms worse.

Physical discomfort

  • Is the person able to let you know that he or she is experiencing physical pain? It is not uncommon for persons with Alzheimer's or other dementias to have urinary tract or other infections. Due to their loss of cognitive function, they are unable to articulate or identify the cause of physical discomfort and, therefore, may express it through physical aggression.
  • Is the person tired because of inadequate rest or sleep?
  • Are medications causing side effects? Side effects are especially likely to occur when individuals are taking multiple medications for several health conditions?

Treating Behavioral Symptoms

Anyone experiencing behavioral symptoms should receive a thorough medical checkup, especially when symptoms appear suddenly. Treatment depends on a careful diagnosis, determining possible causes and the types of behavior the person is experiencing.

Learn more: Treatments for Behavioral Symptoms

Environmental factors

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  • Is the person overstimulated by loud noises, an overactive environment or physical clutter? Large crowds or being surrounded by unfamiliar people — even within one's own home — can be over-stimulating for a person with dementia.
  • Does the person feel lost?
  • Most people function better during a certain time of day; typically mornings are best. Consider the time of day when making appointments or scheduling activities. Choose a time when you know the person is most alert and best able to process new information or surroundings.

Poor communication

  • Are your instructions simple and easy to understand?
  • Are you asking too many questions or making too many statements at once?
  • Is the person picking up on your own stress or irritability?

Learn more:
UTIs and Behavior ChangesCommunication Tips

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How to respond

  • Try to identify the immediate cause.
    Think about what happened right before the reaction that may have triggered the behavior.
  • Rule out pain as a source of stress.
    Pain can cause a person with dementia to act aggressively.
  • Focus on feelings, not the facts.
    Rather than focusing on specific details, consider the person's emotions. Look for the feelings behind the words or actions.
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  • Don't get upset.
    Be positive and reassuring. Speak slowly in a soft tone.
  • Limit distractions.
    Examine the person's surroundings, and adapt them to avoid similar situations.
  • Try a relaxing activity.
    Use music, massage or exercise to help soothe the person.
  • Shift the focus to another activity.
    The immediate situation or activity may have unintentionally caused the aggressive response. Try something different.
  • Decrease level of danger.
    Assess the level of danger — for yourself and the person with Alzheimer's. You can often avoid harm by simply stepping back and standing away from the person. If the person is headed out of the house and onto the street, be more assertive.
  • Avoid using restraint or force.
    Unless the situation is serious, avoid physically holding or restraining the person. He or she may become more frustrated and cause personal harm.
  • Share your experience with others.
    Join ALZConnected, our online support community and message boards, and share what response strategies have worked for you and get more ideas from other caregivers.
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We Can Help

Do you have questions or concerns about your loved one's changing behavior? The Alzheimer's Association is here to help.

Top Resources

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Alzheimer's Association

Our vision is a world without Alzheimer's
Formed in 1980, the Alzheimer's Association is the world's leading voluntary health organization in Alzheimer's care, support and research.